Corey Stringer was the epitome of a National Football League (NFL) All-Pro Offensive Lineman. Standing 6 foot 4 and weighing 330 pounds, it's easy to see how this massive man became a NFL star. It's no wonder his death sent shock waves throughout the world. How could a 27-year-old professional athlete die from the heat? Could his death have been prevented? The answer seems simple and obvious, but overexposure to the heat takes the lives of approximately 400 Americans annually, and most of them are not athletes.

Heat illness covers a wide variety of signs and symptoms the body displays when it is subjected to the heat and humidity of our environment. Athletics is a common arena for heat illness, but it is not the only place heat injuries occur. Many non-athletes are treated every year because of over exposure to the heat. Understanding the causes, signs and symptoms, prevention methods, and common treatments of heat illness can help save someone's life. Maybe even your own.

Heat-related illnesses can occur with one incident in a hot environment or the symptoms can appear after several days in a hot environment. It is important to recognize the first symptoms of heat illness, because your symptoms can become increasingly worse and become a serious health emergency. Recognizing the progressive stages of heat illness-heat edema, syncope, cramps, exhaustion and stroke-can save your life.

Heat edema
Heat edema (swelling) is usually seen in an unacclimated person who is not use to the hot weather. If you begin to sweat profusely, show extreme redness in the face, have low water and sodium retention, and begin to swell in the lower legs, feet, and hands get out of the heat and move to a cool, shady place. Drink cold water and elevate your legs. Your symptoms should resolve quickly once you cool down. To help prevent heat edema, get your body used to being in the heat slowly and steadily over time.

Heat syncope
Heat syncope (fainting or lightheadedness) usually occurs at the end of exercise. If you begin to feel faint, get out of the heat and rest in a cool, shady place. Lie down, elevate your legs, and drink cold water. Acclimatization, an exercise cool-down period, and drinking plenty of water before, during, and after exercise will help prevent heat syncope. Feeling faint or lightheaded can be an early warning sign of heat exhaustion; therefore, if you experience the symptoms, you should use extreme caution with further activity in the heat or you should avoid it completely.
Heat cramps

Tight muscles or spasms during or after intense exercise are signs of heat cramps. The cramping can be very painful and occurs most often in the lower extremities, but they can also occur in the stomach and in the muscles between the ribs. If you have any cramping, get out of the heat, rest in a cool, shady place, massage and stretch the cramped muscle, and drink cold water. For extreme cases, intravenous fluids, under the supervision of a physician, may be needed to rehydrate the body. Muscle cramps can be a sign of impending heat exhaustion; therefore, continued exercise or activity in the heat is not advised until the body is accustomed to the climate and is better hydrated.

Heat exhaustion
Heat exhaustion usually occurs when you sweat a lot and do not drink enough liquids to replace the lost fluids. Heat exhaustion can be accompanied by heat syncope and heat cramps and you may experience nausea and vomiting, headache, blurred vision, a fast heart rate, and fast breathing. Additional symptoms might include mild confusion, agitation, and poor coordination. Many heat exhaustion victims still attempt activity although it is obvious they are impaired. Most heat exhaustion cases are a combination of sodium depletion and water depletion. For treatment, rest in a cool, shaded environment, use moving air to cool the body faster, remove as much of your sweat-soaked clothes as possible, use cold, wet towels to cool the skin, elevate the lower limbs, and drink water to rehydrate or a sports drink to replenish electrolytes. Rapid cooling, such as ice baths, are not recommended. You should see a health-care professional to evaluate your body functions and to determine your return to activity. For prevention you should acclimatize, hydrate, and follow a diet with a little table salt added to your food.

Heat stroke
Heat stroke is the second leading cause of death in athletes, although it is totally preventable. Right before your eyes, heat exhaustion can progress to heat stroke and cause moderate to severe physical impairment, such as hysterical behavior, memory loss, delirium, seizures, coma, loss of consciousness, headache, dizziness, confusion, and weakness. Suspect it in a person whose behavior, mental status, or physical abilities change during heat stress. In most cases of heat stroke, the sweating mechanism is still working. It is a myth that the difference between heat stroke and heat exhaustion is signaled by dry skin, or no sweating in those experiencing heat stroke. If someone shows signs of a heat stroke, cool the body as quickly as possible and call 911. While you wait for emergency medical personnel to arrive, you can move the victim to a cooler place with circulating air, remove as much clothing as you can, and use ice-cold baths, running water, cold towels, ice packs, etc, to cool the body. Massage can be effective to increase circulation in the extremities. If the victim starts to shiver, remove all cooling devices because shivering can increase the core temperature, which you are trying to lower. Dry towels may be needed to make the skin feel warm and eliminate shivering. Do not attempt to transport the victim yourself. Intravenous fluids are needed and emergency medical personnel can provide them onsite and on the way to the emergency room.

To prevent heat stroke, stop exercising when heat cramps or heat exhaustion are evident, become accustomed to the heat slowly, drink plenty of fluids, avoid activity when heat and humidity are severe, follow a proper diet, do not exercise with fever or illness, and do not exercise after heat illness until you are fully rehydrated.

Corey Stringer died of heat stroke. While it may seem easy to look back at his situation and figure out what went wrong, it basically comes down to this: we all have to know our limitations. The human body is an amazing machine; yet, we can use our minds to push our bodies far beyond the natural limits we have. Now that you know the signs and symptoms of heat illness, make sure you protect yourself and the ones you love from becoming the next victim.

Bruce Getz
Columbus, Georgia